197608029-12-30-2025-11-AS-RORN-DRFS6G-20260219123556

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608029
Report Date: 12/29/2025
Date Signed: 12/30/2025 02:24:56 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/18/2025 and conducted by Evaluator Lizeth Villegas

COMPLAINT CONTROL NUMBER: 11-AS-20251218154121

FACILITY NAME:	VISTA DEL MAR SENIOR LIVING		FACILITY NUMBER:	197608029
ADMINISTRATOR:	SUZETTE JOHNSON		FACILITY TYPE:	740
ADDRESS:	3360 MAGNOLIA AVENUE		TELEPHONE:	(562) 595-1559
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90806
CAPACITY:	300	CENSUS: 246	DATE:	12/29/2025
		UNANNOUNCED	TIME BEGAN:	09:06 AM
MET WITH:	Colleen Rozatti		TIME COMPLETED:	03:31 PM

ALLEGATION(S):

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Staff do not ensure that resident's medical needs are met.
Staff do not ensure that resident's dietary needs are met.

INVESTIGATION FINDINGS:

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On 12/29/25 at 9:00 am Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with Colleen Rozatti as the purpose of today’s visit was explained.
The investigation consisted of the following: On 12/22/25 LPA Villegas obtained copies of the staff and resident roster, and copies of the following documents for Resident #1 (R1) Emergency ID form, Physicians report dated: 5/23/24, needs and service plan dated: 9/8/25, and facility notes dated: July 2025- December 2025. On 12/22/25 from 11:00 am- 1pm LPA conducted Interviews with Residents #2-10 (R2-R10). On12/22/25 and 12/29/25 LPA unable to interview R1, as R1 did not wish to be interviewed. On 12/22/25 and 12/29/25 LPA conducted interviews with S1-S6 and conducted a tour of facility.

The investigation revealed the following:
Allegation: Staff do not ensure that residents’ medical needs are met.
It is being alleged that staff are not assisting a resident in care with getting ready for weekly schedule medical appointments, causing scheduled transportation services to cancel.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 11-AS-20251218154121

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: VISTA DEL MAR SENIOR LIVING	FACILITY NUMBER: 197608029
	VISIT DATE: 12/29/2025

NARRATIVE

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On 12/22/25 from 11:00 am- 1pm LPA conducted Interviews with R2- R10 regarding the allegation above. 5 of 9 residents interviewed denied the allegation above and stated that staff assist as needed and staff provide reminders the day before the upcoming appointment. 4 of the 9 residents interviewed reported they do not need assistance with getting ready for appointments. Additionally, 5 of the 9 residents interviewed reported that the facility provides transportation to appointments, 4 of the 9 residents interviewed reported that they do not obtain transportation from the facility if the transportation calendar is fully booked. On 12/22/25 and twice on 12/29/25 LPA attempted to interview R1 but was unsuccessful. On 12/22/25 and 12/29/25 LPA conducted interviews with S1-S6 regarding the allegation above. 5 of 6 staff interviewed denied the allegation above and reported that the staff provide a reminder to residents about upcoming appointments, staff also assist residents get ready for the appointment prior to staff bringing resident down to the lobby to wait for transportation. 1 of 6 staff confirmed the allegation above and reported that there is a lack of communication regarding scheduled appointments, and states that due to lack of communication staff do not have enough notice to get residents ready in a timely manner. On 12/29/25 LPA conducted a review of facility notes dated: December 19^th, 2025, LPA observed that an updated schedule for weekly appointments was provided to R1 as R1 arranges own transportation. On 12/29/25 LPA conducted a review of needs and service plan dated: 9/8/25. Per service plan, R1 needs ongoing assistance with care coordination with outside healthcare and home care providers. Additionally, service plan states care team supports R1 with receiving quality healthcare services by helping coordinate healthcare appointments.

Allegation: Staff do not ensure that residents’ dietary needs are met.

It is being alleged that staff have failed to provide resident in care with food prior to weekly scheduled appointments. On 12/22/25 from 11:00 am- 1pm LPA conducted Interviews with R2- R10 regarding the allegation above. 6 of the 9 residents interviewed denied the allegation above and reported having meals prior to leaving for a scheduled appointment. 2 of the 9 residents interviewed confirmed the allegation above and reported not having a meal prior to scheduled appointment. 1 of 9 residents interviewed stated that they sometimes have a meal as it depends on appointment time. On 12/22/25 and twice on 12/29/25 LPA attempted to interview R1 but was unsuccessful. On 12/22/25 and 12/29/25 LPA conducted interviews with S1-S6 regarding the allegation above. 6 of 6 staff interviewed denied the allegation above and reported that residents are provided with a meal before appointment, or are provided with a packed meal, or are saved a meal for when they return.On 12/29/25 LPA conducted a review of needs and service plan dated: 9/8/25.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20251218154121

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: VISTA DEL MAR SENIOR LIVING	FACILITY NUMBER: 197608029
	VISIT DATE: 12/29/2025

NARRATIVE

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Per service plan, R1 requires a special diet. On 12/29/25 LPA conducted a tour of the kitchen facility, LPA observed all special diets, and dietary needs are printed and displayed on kitchen wall. The Kitchen staff also have a binder with all residents and their dietary needs.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

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